Regional anesthesia and pain medicine
-
Reg Anesth Pain Med · Nov 2007
Multicenter StudyFactors predicting success and failure for cervical facet radiofrequency denervation: a multi-center analysis.
The concept of radiofrequency denervation has recently come under question in light of several studies showing minimal to no benefit. One possibility proposed for these negative outcomes is poor selection criteria. Unlike virtually all other spine interventions, the factors associated with success and failure for cervical facet denervation have yet to be determined. The purpose of this study is to determine which demographic, clinical and treatment factors are associated with cervical facet radiofrequency denervation outcomes. ⋯ Selecting patients based on key clinical variables may increase the chance of treatment success for cervical facet radiofrequency denervation.
-
Reg Anesth Pain Med · Nov 2007
Case ReportsStimulating catheter as a tool to evaluate peripheral nerve function during hip rotationplasty.
Stimulating catheters have been introduced into clinical practice to confirm perineural localization of the catheters. The muscular twitch induced over the catheter may be used to evaluate nerve function intraoperatively. Therefore, the function of the sciatic nerve was evaluated during major cancer surgery of the femur. ⋯ The use of epidural stimulating catheters as a tool to monitor nerve function is a novel and simple procedure to monitor nerve function intraoperatively and to enable good postoperative pain control.
-
Reg Anesth Pain Med · Nov 2007
Local anesthetics have different mechanisms and sites of action at recombinant 5-HT3 receptors.
In addition to their blockade of voltage-dependent sodium channels, the action of local anesthetics at 5-hydroxytryptamine-3 (5-HT3) receptors may be clinically relevant. Because local anesthetics have different clinical properties, we have tested the hypothesis that differences in interactions at the 5-HT3 receptor may be clinically relevant by investigating the effects of 4 local anesthetics on recombinant wild-type and 4 mutant 5-HT3A receptors. ⋯ The ester type local anesthetics, procaine and tetracaine, may act at a different site on the 5-HT(3A) receptor and with a different mechanism than the amide-type local anesthetics. Clinical differences between local anesthetics may be at least partially due to differences in interactions at the 5-HT3A receptor.